Cancer patients are among the topmost beneficiaries of the Pradhan Mantri Jan Arogya Yojana (PMJAY). Medical oncology is the highest utilised package under the health scheme in the tertiary care sector followed by cardiology, orthopaedics, urology and radiation oncology. The scheme has seen 77% utilisation in tertiary and 23% in secondary healthcare.
“There is definitely a lot of utilisation for chemotherapy and services like dialysis,” Malti Jaswal, senior consultant with the World Bank, said. She was presenting her observations on Ayushman Bharat at the Confederation of Indian Industry Healthcare, Pharma and Medtech Conclave in Mumbai on Wednesday.
“It is believed that the scheme will result in 1.7 crore hospitalisations in the first year. Of the total spending, almost 40% or ₹5,260 crore would go to public sector hospitals and ₹7,250 crore or 60% to the private sector,” she said.
‘Game changer’
Stakeholders in the healthcare industry who gathered at the event touted Ayushman Bharat as a game changer. Yet, many top private players have chosen not to be empanelled because of the low package rate offered under the scheme. “Fundamentally, I do believe that it is a very good scheme. But currently, we are not sure if we can be a part of it,” said Dr. S. Narayani, zonal director, Fortis Hospital.
She suggested that cost can be brought down significantly if the government thinks on the lines of allowing reuse of consumables. “The government can think of formalising it,” she said.
Dr. Shubnum Singh, director of Max Healthcare, also echoed Dr. Narayani’s thoughts. “It’s a brilliant scheme and universally appealing. But there is a caveat. We cannot provide a service below the cost,” she said.
Dr. Sudhakar Shinde, chief executive officer of Maharashtra’s health insurance scheme for the poor — Mahatma Phule Jan Arogya Yojana — said that there are ongoing discussions on ways to improve the package rates and reuse of devices.
Study on package rates
According to Ms. Jaswal, for PMJAY, a study has been undertaken for revising package rates. “Even if all the packages are not considered, the most utilised 100 to 200 packages may be dealt with first,” she said.
